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Medications for Systemic Fungal Infections

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Medication	Uses	Potential Adverse Effects
Amphotericin BAmphotericin B	Most fungal infections	Conventional formulation: Acute infusion reactions, neuropathy, gastrointestinal (GI) upset, renal failure, anemia, thrombophlebitis, hearing loss, rash, hypokalemia, hypomagnesemia
Amphotericin BAmphotericin B	Most fungal infections	Lipid formulations: Infusion reactions, renal failure
AnidulafunginAnidulafungin	Aspergillosis Candidiasis, including candidemia	Hepatitis, diarrhea, hypokalemia, infusion reactions
CaspofunginCaspofungin	Aspergillosis Candidiasis, including candidemia	Phlebitis, headache, GI upset, rash
FluconazoleFluconazole	Mucosal and systemic candidiasis Cryptococcal meningitis Coccidioidal meningitis	GI upset, rash, hepatitis, QT prolongation
Flucytosine†Flucytosine†	Candidiasis (systemic) Cryptococcosis	Pancytopenia due to bone marrow toxicity, neuropathy, nausea, vomiting, hepatic and renal injury, colitis
Isavuconazonium (isavuconazole)‡ Isavuconazonium (isavuconazole)‡	Aspergillosis Mucormycosis	Nausea, vomiting, hepatitis, QT shortening with no evidence of cardiac risk, infusion-related reactions
ItraconazoleItraconazole	Dermatomycosis Histoplasmosis, blastomycosis, coccidioidomycosis, sporotrichosis, aspergillosis	Hepatitis, GI upset, rash, headache, dizziness, hypokalemia, hypertension, edema, QT prolongation, heart failure
MicafunginMicafungin	Aspergillosis Candidiasis, including candidemia	Phlebitis, hepatitis, rash, headache, nausea, acute intravascular hemolysis
Posaconazole§Posaconazole§	Aspergillosis Mucormycosis Prophylaxis for invasive fungal infection Oral candidiasis refractory to fluconazoleOral candidiasis refractory to fluconazole	Hepatitis, GI upset, rash, QT prolongation
RezafunginRezafungin	Candidemia Invasive candidiasis	Photosensitivity, abnormal liver tests, infusion-related reactions (flushing, sensation of warmth, urticaria, nausea, chest tightness)
VoriconazoleVoriconazole	Invasive aspergillosis Candidiasis Fusariosis Scedosporiosis	GI upset, transient visual disturbances, peripheral edema, rash, hepatitis, QT prolongation
* This adverse effect is less common with lipid formulations than with the conventional formulation.
† Amphotericin B is used with flucytosine for serious † Amphotericin B is used with flucytosine for seriousCandida and cryptococcal infections.
‡ Isavuconazole is given as the prodrug isavuconazonium; 372 mg of ‡ Isavuconazole is given as the prodrug isavuconazonium; 372 mg ofisavuconazonium is equivalent to 200 mg of isavuconazole.
§ The delayed-release tablets, delayed-release oral suspension, and immediate-release oral suspension of posaconazole are NOT interchangeable because of differences in dosing.§ The delayed-release tablets, delayed-release oral suspension, and immediate-release oral suspension of posaconazole are NOT interchangeable because of differences in dosing.